SINGAPORE (THE NEW PAPER) - She may be the first Singaporean to undergo a ground-breaking medical procedure called ovarian tissue cryopreservation.

But all Madam Siti Nurjannah Sapiee, 32, is grateful for is that it enabled her to be a mother.

Her journey to motherhood began with a devastating roadblock.

Just three months before her planned wedding, in November 2009, Madam Siti, who was then 26, was shaken by two diagnoses - cancer and infertility.

The former primary school teacher was diagnosed with synovial sarcoma of the thigh, a rare cancer of the soft tissues that typically occurs near the large joints of the arms or legs.

OVARIAN TISSUE HARVESTED & FROZEN

Madam Siti hopes to try for another child as her reimplanted ovaries are viable for only five years.

Soon after her cancer treatment, Madam Siti Nurjannah Sapiee was also put on hormone replacement therapy to ease the effect of premature menopause, which had been brought about by the temporary removal of her ovarian tissue.

In the ovarian tissue cryopreservation procedure, doctors harvested tissue that stores the eggs from both of Madam Siti's ovaries.

A special freezing technique was used to preserve that portion of tissue, also known as the cortex.

Ms Joyce Mathew, chief embryologist in NUH's Department of Obstetrics & Gynaecology, said: "The most crucial part of the freezing procedure in the laboratory was to ensure that there would be no freeze damage to the egg cells in the cortical tissue."

By March 2013, Madam Siti had recovered from cancer and was ready to have children.

The frozen tissue was thawed and rinsed with a special thawing solution, then reimplanted into her body via a mini laparotomy.

The surgical procedure involves making a large incision through the abdominal wall to gain access into the abdominal cavity and it was done with the use of extremely fine sutures.

INFERTILITY

To make matters worse, she was told that chemotherapy might render her infertile.

Madam Siti, who is now a housewife, said: "The most heartbreaking thing to me was remembering that my fiance wanted three kids and I felt I couldn't give him what he wanted."

So she postponed her wedding to November 2010 and focused on battling her illness to pursue her chances of having children.

Madam Siti was referred to Dr Anupriya Agarwal, a consultant at the National University Hospital (NUH) Women's Centre's Department of Obstetrics & Gynaecology, by her oncologist, Dr Andrea Wong.

Before the start of her cancer treatment, the doctors discussed how to sustain her fertility.

They suggested ovarian tissue cryopreservation, a procedure that involves the removal of ovarian tissue from Madam Siti's body and keeping it in frozen storage until after her recovery.

In-vitro fertilisation, an alternative procedure, was not an option as Madam Siti was engaged, but not married at that time.

"You don't know how much you want a baby until somebody tells you that you can't have one," she said tearfully.

About three years later, in March 2013, Madam Siti was confirmed to be cancer-free and was ready for the ovarian tissue to be reimplanted into her body.

EXTREMELY CONCERNED

Her husband, Mr Raihan Haji Rajin, 32, told The New Paper that he was still extremely concerned.

"Even though she was cancer-free, I didn't want her to neglect her health just so that she could conceive my child. I wanted her to raise it with me," said the primary school teacher.

Madam Siti's menstrual cycle returned three months after the ovarian tissue was reimplanted.

Over a year later, in October 2014, the moment she had been dreaming of finally came.

Mr Raihan said: "She woke me up one morning and showed me a pregnancy test that showed a positive result. I told her to try two more times and all three tests were positive.

"At that time, she was already excited, but I didn't want to raise our hopes, to be disappointed in the end. That's why I was still quite hesitant and wanted to wait until we received confirmation from a doctor."

Madam Siti said it was not until the third month of her pregnancy, when the gynaecologist showed them a sonogram of their baby, that she and her husband really believed they would be having a child.

She recalled having an easy pregnancy. Once, she had a craving for belacan that could be bought only in Malacca.

"The funny thing is I didn't even want to eat it, I just wanted to smell it," she said with a chuckle.

On May 21 this year, Madam Siti gave birth to Nur Hannah A'qiylah.

Weighing 2.7kg at birth, baby Hannah is reportedly one of only 21 babies worldwide who was conceived naturally following ovarian tissue cryopreservation, according to NUH.

Her birth is reportedly the first in Asia.

Madam Siti said: "If I could advise anyone who is going through the same thing I did, I would tell them to have faith and not give up. Hannah is proof that miracles still exist in this world."

She now faces a time limit: Her reimplanted ovaries are viable for only five years. Otherwise, she will have to go through the entire procedure all over again.

She said: "I am very happy and contented right now. But I hope to try again for another child in the next five years."

The Straits Times

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